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crrab ii > GI Tract & Vessels (Ach) - W2 > Flashcards

GI Tract & Vessels (Ach) - W2 Flashcards

1
Q

What is the function and features of the stomach?

A
  • receives food + saliva from esophagus and acts as reservoir where the digestive enzymes can break it down.
  • Parts
    • greater curvature - attaches greater omentum
    • lesser curvature - lesser omentum
    • fundus - left 5th interspace
    • cardiac orifice - has cardiac sphincter
    • body
    • pylorus
    • rugae - folds
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2
Q

What are the parts of the pylorus of the stomach, and what does the pyloric sphincter do?

A
  • Pyloric antrum
  • pyloric canal
  • pyloric sphincter
    • controls passage of chyme into duodenum
    • true sphincter - thick ring of circular muscle
    • normally in tonic contraction
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3
Q

What are rugae, where are they found and what is their purpose?

A
  • folds of mucosa inside stomach
  • increase surface area
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4
Q

Most common of the hiatal hernias, how is it acquired, what is it a risk factor for and who is the most common population?

A
  • Acquired hiatal hernias
    • ​most common (99%)
    • occur in middle-aged people
    • gastroesophageal region –> slides superiorly into thorax through lax esophageal hiatus
      • risk factor for GERD
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5
Q
  • What is the least common acquired hiatal hernia?
  • what does it involve?
  • When do you repair?
  • what is it a risk for?
A
  • Paraesophageal (rolling) hiatal hernia
    • less common (1%)
    • pouch of perineum that contains the fundus of the stomach and extends for the esophageal hiatus ANTERIOR to the esophagus
    • associated with pain, nausea, and vomitting
      • ​refer for REPAIR
    • high incidence of incarceration & ischemia
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6
Q

Peptic Ulcer

  • what is it
  • common site
  • what can it cause
A
  • erosion of the mucous membranes of the stomach or duodenum
  • ONLY occurs in tissues in contact with gastric juices
  • most common in duodenal cap (80%)
    • 2nd most common is posterior wall of duodenum.
  • erosion could perforate the wall & erode pancrease
    • gastroduodenal artery massive hemorrhage
  • associated w/H. pylori
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7
Q

How can you tell the difference between jejunum & ileum?

A
  • Jejunum
    • often EMPTY
    • thicker, redder, more vascular
    • well developed circular folds of mucosa (plicae circularis)
    • few arcade arterioles - much longer arterioles
    • areas fat free
  • Ileum
    • lymphatic nodules (peyer’s patches)
    • more fat
    • numerous, shorter arcade arterials
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8
Q

What are 3 things found on the large intestine and what are they?

A
  • Teniae coli - outer longitudinal muscle fibers that are confined to 3 parallel bands
  • Haustra - sacculations between teniae
  • Appendices epiploicae - small sacs of fat covered w/peritoneum suspeneded from the external surface
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9
Q

What does inflammation of the appendix cause?

Where is pain referred intially and why?

What will become affected late?

A
  • Appendicitis
    • when it ruptures can lead to peritonitis
  • referred pain to T10 due to autonomic nerves and where they convege
  • late = rebound tenderness at McBurney’s point - inflammation affects SNS of parietal layer
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10
Q

What is ulcerative colitis and what may be needed?

A
  • severe inflammation and ulceration of the colon and rectum
  • may need colectomy = permanet opening between ileum and anterior abdominal wall
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11
Q

What is a colostomie?

A
  • establishes an opening between various parts of the colon and anterior abdominal wall - creates an artificial anus
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12
Q

What is a diverticululum?

What causes it?

Who is it common in?

Most commonly found where?

A
  • Diverticululum
    • abnormal pouch that forms in the wall of the colon caused by increased intracolonic pressure pushing against weak intestinal wall.
  • most commonly in sigmoid colon
  • 10% of people over 40
  • usually asymptomatic until inflamed
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13
Q

What are the 3 main arteries off the abdominal aorta?

A
  • Celiac Trunk
  • Superior mesenteric artery
  • Inferior Mesenteric artery
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14
Q

What does the celiac trunk supply?

where does it arise?

What are its branches?

A
  • supplies foregut
  • arises from abdominal aorta T12
  • Branches
    • left gastric
    • Common hepatic
    • Splenic
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15
Q

What are the two branches of the common hepatic?

A
  • Hepatic artery proper
  • Gastroduodenal artery
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16
Q

What are the branches of the hepatic artery proper?

A
  • Right gastric - lesser curvature
  • Left hepatic - left lobe of the liver
  • Right hepatic - right lobe of liver
  • Cystic artery - usually arises from right hepatic to supply the gallbladder
17
Q

What are the branches of the splenic artery?

Where does splenic lie and what is its course?

A
  • looks TORTUOUS - lies above pancreas
  • Branches
    • Pancreatic branches
    • Short gastric (fundus)
    • Left gastro-omental (gastro-epiploic)
18
Q

What are the branches of the gastroduodenal artery?

A
  • supraduodenal
  • superior pancreaticoduodenal arteries
  • right gastro-omental (gastro-epiploic)
19
Q

Superior Mesenteric Artery

  • What does it supply?
  • Where does it arise?
    • Where do its branches go and what do they supply?
A
  • midgut
  • arises from abdominal aorta 1cm below celiac trunk at L1
  • Small intestine
    • inferior pancreaticodudoenal arteries
    • jejunal
    • ileal
  • large bowel
    • ​ileocolic - has appendicular branch
    • right colic
    • middle colic- transverse mesocolon
20
Q

Inferior Mesenteric Artery

Supplies?

Arises?

Branches?

A
  • hindgut
  • arises 1.5 inch above abdominal aorta bifurcation at L3
  • Branches - gut to lower rectum
    • Left colic artery
    • Sigmoid arteries
    • Superior rectal artery (termination of inferior mesenteric)
      • Marginal artery
21
Q

What artery do the SUPERIOR mesenteric and INFERIOR mesenteric arteries form an anastomes between?

A

left colic artery anastamoses with middle colic (of superior mesentery)

22
Q

What artery at the ileocolic junction forms an anastamoes with the superior rectal artery - forms an anatomoes between COLIC ARTERIES

A

marginal artery of Drummond

23
Q

What are the 2 sets of capillaries though which the portal system flows?

A
  1. GI capillaries
  2. Liver capillary beds
24
Q

What vein drains the foregut?

A

splenic vein

25
Q

How is the hepatic portal vein formed?

A
  • splenic vein recives gastric, gastroepiploic and pancreatic veins
  • receives inferior mesenteric vein
  • joins with superior mesenteric vein for form the hepatic portal vein

forms posterior to the neck of the pancreas

26
Q

What anastomoses is important for forming esophageal varices?

A
  • esophageal tributes of azygos and hemiazyogus veins w/tributaries of left gastric vein
27
Q

What anastomoses is responsible for forming caput medusae (engorgement of epigastric veins)

A
  • Paraumbilical veins w/superior, inferior, and superficial branches of epigastric veins
28
Q

What anastamoses is responsible for forming internal hemorrhoids

A
  • superior rectal vein (portal)
  • middle rectal vein
  • inferior rectal vein
29
Q

What is the cause of portal hypertension?

A
  • increase in pressure and engorgement of vessels from obstruction of portal circulation
    • within liver, tumor/cirrhosis
    • outside liver - compression of portal vein (tumor)
30
Q

What are the symptoms of portal hypertension?

A
  • ascites
  • GI bleeding - esophageal varices, rectal hemorrhoids
  • splenogmegaly
  • caput medusae
31
Q

What receives lymph from the abdomen

A

cisterna chyli

32
Q

Where does lymph flow from the jejunum, ileum and colon?

A

aorta

33
Q

What are the 3 nodes that lie adjacent to each of the unpaired arteries

A

celiac node

superior mesenteric node

inferior mesenteric node

34
Q

What organs does the celiac trunk supply (6)

A
  1. stomach
  2. duodenum
  3. liver
  4. gall bladder
  5. pancrease
  6. spleen
35
Q

If the gastric ulcer erodes the stomach wall, what artery could cause a GI bleed?

A

splenic artery

36
Q

What organs does superior mesenteric artery supply?

A
  1. Pancreas
  2. duodenum
  3. jejunum
  4. ileum
  5. cecum, appendix
  6. ascending colon
  7. hepatic flexure
  8. proximal 1/3 of transverse colon
37
Q

What does the inferior mesenteric vessels supply?

A
  • distal 2/3 of transverse colon
  • descending colon
  • sigmoid colon
  • rectum
38
Q

What areas of the colon are prone to ischemia?

A
  • right colon - marginal artery is poorly developed
  • splenic flexure
  • rectosigmoid junction - distal to last collateral connectiion
39
Q

What vein enters the liver and what vein leaves the liver?

A

Hepatic portal vein enters

hepatic vein leaves

crrab ii (26 decks)

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